If you look around, you may be noticing a trend in the healthcare space: more and more providers switching to an out-of-network model. Reimbursements from insurance companies are on the decline making it more difficult for healthcare providers to focus on quality care.
Cash-based practice allows providers to put the patient first.
In a cash-based treatment model, the physical therapist enters into an agreement with the patient to provide physical therapy services in a manner that both parties have determined will help them reach treatment goals most efficiently. The patient pays at the time of service, allowing the therapist to focus attention on providing the best possible care while keeping administrative costs low. Patients in an out-of-network model can expect to see their therapist 1 x every 1-3 weeks because of the higher quality care provided at each session.
Insurance is not billed at PIVOT, and that can save you money. As a Cash-based practice, clients pay at the time of their visit, and may submit a superbill to their insurance provider. A superbill is a detailed document that allows clients to bill their insurance company directly. It includes information similar to an insurance claim form, such as the date of the service provided, procedure codes and a total balance due. This enables us to provide the high-level of care you deserve.
For superbill submissions, we recommend reimbursify.com. We will help you with the step by step process on your first visit!
Through PIVOT's unique treatment style, you will actually save money in the long run.
To explain this, let us briefly define these insurance terms:
Deductible: The amount of money you have to pay out of pocket before any of your insurance benefits kick in. For the typical family plan, this can be anywhere from $5,000 to over $10,000 per year…money that you pay before insurance covers anything. Some plans have one deductible and others have two deductibles, one for in-network and one for out-of-network services.
Copay: An amount you pay each time you receive a specified service. For physical therapy, I’ve seen this range from $25 to $60 per visit.
Coinsurance: The percentage of the cost of a service that you pay out of pocket. I’ve seen this range from 20% to 50% for physical therapy services.
Depending on your insurance plan, your medical costs will be divided up one way or another between each of these categories. So, let’s look at this in regards to traditional insurance-based physical therapy.
Let’s say you have any injury or pain and decide to go to a traditional PT clinic. You’ll probably have a plan of care to go 2-3 times per week for 4-8 weeks. The cost per session could be anywhere from $50-$300 depending on what the PT does with you and how long you are there. Not to mention, your PT may be seeing between 2 and 3 people at the same time and the majority of your time may be spent with an assistant, aide, or student who is “taking you through your exercises.”
Technically, the company “takes your insurance” but payment still comes out of your pocket in full until your deductible is met. The only thing is you won’t know what your bill is until after the insurance company processes everything and returns it to the PT company, who then provides you with the bill…this may take weeks or months after you’re already done with treatment.
If you are able to meet your deductible, you’re still on the hook for any copay or coinsurance for each session, which can range anywhere from $25 to $60+ per visit.
PIVOT is not your typical PT clinic. We are a cash based, out-of-network provider who works for the patients, and not for insurance companies. Our performance and overall wellness based model allows people to recover from injuries, decrease pain, and optimize physical performance without being limited by the boundaries of insurance providers. Even though we are out-of-network a patient can still submit a superbill to their insurance provide allowing for reimbursement depending on plan.
Are you ready for the snow? Is your body ready for the snow? LET'S FIND OUT!
FREE Group Session or Individual Session $49!
Come hang out with us! Bring your friends and make it a friendly little competition. We will run you through a number of assessments testing strength, balance, flexibility, and more! You will take a way a scorecard with recommendations on how to make the most of your snowy season and most importantly an INJURY FREE season filled with fun!
Morning group sessions available on September 30th and October 1st. Individual appointments available during the week at both locations!